| NPI | 1689923948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 278692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09847500) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2024-03-22 |